GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE UNSTARRED QUESTION NO. 2052 TO BE ANSWERED ON 21ST DECEMBER, 2018 PREVENTION OF CANCER

2052. SHRI BHARTRUHARI MAHTAB: SHRI RAHUL SHEWALE: SHRIMATI DARSHANA VIKRAM JARDOSH: SHRIMATI NEELAM SONKER: SHRI SANJAY DHOTRE: SHRI SUKHBIR SINGH JAUNAPURIA: SHRI SANJAY KAKA PATIL: SHRI :

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether the cases of cancer in the country are increasing day-by-day despite spending crores of rupees by the Government to eradicate the disease and if so, the reaction of the Government thereto;

(b) the number of cases of cancer and death from cancer reported since 2014 along with the funds allocated to prevent the cancer during the said period, State/UT and year-wise;

(c) the salient features of the Tertiary Care for Cancer scheme being run in the country;

(d) the number of proposals received from various States under the said scheme during the last three years along with present status indicating the funds provided/utilized during the said period, State/UT-wise; and

(e) whether the Government has received any complaints of irregularities in the implementation of the said scheme and if so, the details thereof and action taken in this regard, State/UT-wise? ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SMT. ANUPRIYA PATEL)

(a) to (e): As per the Indian Council of Medical Research’s Cancer Registry data report on “Three-year Report of Population Based Cancer Registries: 2012-2014, Bengaluru, 2016”, the estimated number of incidence of cancer cases in the country is increasing. The estimated number of incidence of cancer cases and deaths due to cancer reported from 2014 to 2018, State/UT wise are at Annexure-I and II, respectively.

To support the State/UTs for interventions upto district level, the Government of India is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) under National Health Mission (NHM). The focus is on three common cancers (oral, breast and cervical). Funds for the programme are released under the NCD Flexipool, details of which are at Annexure-III. In addition, population based prevention, control, screening and management for hypertension, diabetes and common cancers (oral, breast and cervical) is also being implemented in more than 200 districts under NHM.

Under the Strengthening of Tertiary Care Cancer facilities scheme under NPCDCS, financial assistance is provided for setting up of State Cancer Institutes (SCIs) and Tertiary Care Cancer Centres (TCCCs) in different parts of the country. The maximum permissible assistance for SCI is Rs. 120 crores and for TCCC is Rs. 45 crores, which includes State share of 40%, except for North-Eastern and Himalayan States where the State share is 10%. The broad objective of the scheme is to develop capacity for tertiary care for cancer in States. Assistance under this scheme is for procurement of radio therapy equipment, diagnostic equipment, surgical equipment, enhancement of indoor patient facility for cancer and such other purposes relevant for diagnosis, treatment and care of cancer. Upto 30% of the approved cost can be used for construction.

The details of proposals for setting up of SCIs and TCCCs received from various States/UTs under the scheme is at Annexure-IV. The details of funds released as 1st installment of Central share to State Governments for setting up of SCI and TCCC, State/UT- wise, is at Annexure-V.

Some issues are raised by individuals/ organizations on implementation of the scheme and appropriate action is taken in such cases after examining the facts relating to them. Annexure-I

Estimated Incidence of cancer cases in India - State/UT - All sites - Both sexes (2014-2018)

States 2014 2015 2016 2017 2018 Jammu & Kashmir 14115 14864 15652 16480 17351 Himachal Pradesh 7425 7722 8029 8348 8679 Punjab 30002 31214 32474 33781 35137 Chandigarh 1162 1217 1274 1335 1398 Uttaranchal 11240 11796 12381 12995 13640 Haryana 27933 29240 30611 32049 33558 18356 19168 20015 20899 21821 75642 79160 82836 86675 90686 Uttar Pradesh 222615 233659 245231 257353 270053 Bihar 117603 123949 130628 137656 145051 Sikkim 467 473 479 485 490 Arunachal Pradesh 1231 1252 1272 1292 1313 Nagaland 1288 1294 1300 1309 1318 Manipur 2836 2916 2998 3082 3168 Mizoram 1585 1618 1652 1687 1723 Tripura 2139 2169 2199 2229 2260 Meghalaya 3184 3246 3311 3376 3442 Assam 31124 31474 31825 32177 32530 West Bengal 99339 103532 107906 112466 117220 Jharkhand 37031 38947 40959 43071 45289 Orissa 45736 47666 49674 51763 53936 Chattisgarh 28738 30239 31817 33477 35223 Madhya Pradesh 81034 85078 89315 93754 98403 Gujarat 66952 70171 73551 77097 80820 Daman & Diu 339 385 440 504 579 Dadra & Nagar Haveli 421 457 497 542 591 Maharashtra 122256 127390 132726 138271 144032 Telangana 38494 40177 41939 43784 45713 Andhra Pradesh 53570 55776 58072 60475 62978 Karnataka 67237 70302 73511 76867 80381 Goa 1587 1655 1726 1801 1881 Lakshadweep 77 82 89 96 104 Kerala 37550 39672 42004 44566 47382 Tamil Nadu 76091 78512 80999 83554 86180 Pondicherry 1428 1510 1596 1687 1783 Andaman & Nicobar Islands 402 415 429 443 458 Total 1328229 1388397 1451417 1517426 1586571 Ref: Three-year Report of the PBCRs: 2012-2014, Bengaluru, 2016 *Projected cancer cases for India were computed using a projected incidence rates and the population (person-years)

Annexure-II Estimated Mortality of cancer cases in India - State/UT - All sites - Both sexes (2014-2018)

States 2014 2015 2016 2017 2018 Jammu & Kashmir 7144 7525 7925 8345 8788 Himachal Pradesh 3742 3893 4048 4210 4378 Punjab 15171 15784 16423 17084 17771 Chandigarh 590 618 646 678 709 Uttaranchal 5667 5949 6245 6556 6883 Haryana 14135 14797 15491 16219 16983 Delhi 9290 9699 10127 10573 11039 Rajasthan 38202 39985 41848 43795 45829 Uttar Pradesh 112514 118115 123985 130134 136579 Bihar 59431 62651 66040 69607 73361 Sikkim 236 240 242 245 248 Arunachal Pradesh 628 638 649 659 670 Nagaland 662 665 667 672 676 Manipur 1419 1460 1500 1542 1585 Mizoram 808 824 841 859 878 Tripura 1094 1109 1125 1140 1156 Meghalaya 1644 1676 1710 1744 1777 Assam 15853 16029 16206 16383 16561 West Bengal 50110 52231 54443 56750 59154 Jharkhand 18683 19653 20671 21741 22864 Orissa 23043 24019 25035 26091 27190 Chattisgarh 14472 15231 16030 16868 17751 Madhya Pradesh 40917 42964 45110 47358 49713 Gujarat 33832 35466 37182 38983 40873 Daman & Diu 176 200 229 263 303 Dadra & Nagar Haveli 215 233 254 276 301 Maharashtra 61732 64332 67035 69843 72762 Telangana 19385 20235 21126 22058 23033 Andhra Pradesh 26970 28082 29244 30458 31725 Karnataka 33881 35430 37052 38747 40523 Goa 799 834 870 908 948 Lakshadweep 39 42 45 48 53 Kerala 18827 19892 21062 22348 23761 Tamil Nadu 38310 39537 40796 42091 43422 Pondicherry 717 759 802 848 895 Andaman & Nicobar Islands 203 210 217 224 232 Total 670541 701007 732921 766348 801374 Ref: Three-year Report of the PBCRs: 2012-2014, Bengaluru, 2016 *Projected mortality cases for India were computed by applying Mumbai Mortality/Incidence (MI) ratio to the projected incidence cancer cases. Annexure-III

Releases of funds under NHM (N C D Flexi Pool)

(NPCDCS is part of NCD Flexipool)

(Rs. in Lakh)

S No. States/UTs 2016-17 2017-18 1 Bihar 1804 4726 2 Chhatisgarh 1485 3469 3 Jharkhand 1511 0 4 Madhya Pradesh 3540 5048 5 Odisha 1955 1785 6 Rajashthan 2678 6378 7 Uttar Pradesh 7181 15132 8 Himachal Pradesh 324 644 9 Jammu & Kashmir 1459 2357 10 Uttarakhand 890 186 11 Andhra Pradesh 3082 3645 12 Telangana 1123 2012 13 Goa 0 0 14 Gujarat 2132 4754 15 Haryana 380 1388 16 Karnataka 2134 8284 17 Kerala 693 1211 18 Maharashtra 3768 6208 19 Punjab 835 1726 20 Tamil Nadu 2145 5461 21 West Bengal 2485 2303 22 Chandigarh 46 109 23 Delhi 564 1289 24 Puducherry 39 125 25 Andaman & Nicobar Islands 121 108 26 Dadra & Nagar Haveli 82 89 27 Daman & Diu 39 19 28 Lakshadweep 0 0 29 Arunachal Pradesh 841 1606 30 Assam 5533 6046 31 Manipur 250 675 32 Meghalaya 531 779 33 Mizoram 214 1297 34 Nagaland 183 637 35 Sikkim 158 115 36 Tripura 266 821 Total 50471 90432 Annexure-IV

List of proposals received for setting up of SCIs and TCCCs under Strengthening of Tertiary Care Cancer scheme of NPCDCS.

S. No States/UTs Tertiary Care Cancer Centre State Cancer Institute (TCCC) (SCI) 1. Andhra Pradesh ACSR Government Medical College, Nellore Kurnool Medical College, Kurnool 2. Assam Assam Medical College, Dibrugarh Gauhati Medical College & Hospital, Guwahati 3. Arunachal Government Hospital, Naharlagun - Pradesh 4. Bihar 1. Dharbhanga Medical College, Indira Gandhi Institute of Medical Sciences Dharbhanga (RCC), Patna 2. Jawaharlal Nehru Medical College, Bhagalpur 5. Chhattisgarh Central Hospital, SECL, Manendragarh, District Chhattisgarh Institute of Medical Sciences, Koriya Bilaspur 6. Delhi Lok Nayak Hospital (Maulana Azad Medical - College) 7. Gujarat 1. Pandit Deen Dayal Upadhyay Gujarat Cancer Research Institute (RCC), Medical College, Rajkot Ahmedabad 2. Government Medical College and SSG Hospital, Vadodara 8. Goa Goa Medical College, Panaji, Goa. - 9. Haryana Civil Hospital, Ambala Cantt - 10. Himachal 1. Indira Gandhi Medical College (RCC) - Pradesh Shimla 2. Lal Bahadur Shastri Govt. Medical College & Hospital, Mandi 11. Jammu & 1. District Hospital, Kishtwar, 1. Government Medical College Kashmir 2. District Hospital, Udhampur (RCC)Jammu 3. District Hospital, Kupwara, 2. Sher-I-Kashmir Institute of Medical Sciences (RCC), Srinagar. 12. Jharkhand MGM Medical College, Jamshedpur Rajendra Institute of Medical Sciences , Ranchi 13. Karnataka 1. Mandya Institute of Medical Kidwai Memorial Institute of Sciences, Mandya Oncology(RCC), Bangaluru 2. Gulbarga Institute of Medical Sciences, Gulbarga 14. Kerala Govt. Medical College, Kozhikode Regional Cancer Centre, Thiruvananthapuram 15. Madhya 1. G. R. Medical College, Gwalior Netaji Subhas Chandra Bose Medical Pradesh 2. District Hospital, Vidisha College, Jabalpur. 16. Maharashtra 1. Vivekanand Medical Foundation & Government Medical College, Aurangabad Research Centre, Latur 2. Rashtrasant Tukdoji Regional Cancer Hospital & Research Centre, Nagpur 17. Manipur Regional Institute Of Medical - Sciences (RIMS) , Imphal 18. Nagaland District Hospital, Kohima - 19. Mizoram Civil Hospital Aizawl - 20. Odisha 1. Burla Medical College (Dist. Regional Cancer Centre, Cuttack Sambalpur) 2. M.K.C.G. Medical College Hospital, Berhampur 3. District Hospital, Bhawanipatna, District Kalahandi 21. Punjab 1. District Hospital, Hoshiarpur Government Medical College, Amritsar 2. District Hospital, Fazilka 22. Rajasthan 1. S. P. Medical College, Bikaner SMS Medical College, Jaipur 2. Govt. Medical College/District Hospital, Jhalawar 23. Sikkim Multispecialty Hospital at Sichey, Sikkim -

24. Tamil Nadu Madurai Medical College & Hospital, Madurai Cancer Institute (RCC) Adyar, Chennai

25. Telangana - M.N.J. Institute of Oncology (RCC), Hyderabad 26. Tripura - Cancer Hospital(RCC), Agartala 27. Uttar Pradesh 1. Sanjay Gandhi Institute of Medical Kamla Nehru Memorial Hospital (RCC), Sciences, Lucknow Allahabad 2. Jawaharlal Nehru Medical College, AMU, Aligarh 3. Government Medical College, Jhansi 4. Institute of Medical Sciences (BHU) Varanasi 28. Uttarakhand Himalayan Institute of Medical Sciences, Government Medical College, Haldwani Dehradun 29. West Bengal 1. Government Medical College, - Burdwan 2. Murshidabad Medical College & Hospital 3. Sagore Dutta Memorial Medical College and Hospital, Kolkata Total 44 20 Annexure-V

List of State Cancer Institutes (SCIs) and Tertiary Care Cancer Centres (TCCCs) approved till date and funds as 1st instalment of Central Share released to the State Governments.

S No State Name of the Institute SCI/ Amount TCCC Released (Rs. in Crore)

1 Andhra Pradesh Kurnool Medical College, Kurnool SCI 54.00 2 Assam Gauhati Medical College & Hospital, Guwahati SCI 80.9325 3 Bihar Indira Gandhi Institute of Medical Sciences, Patna SCI 33.06 4 Delhi Lok Nayak Hospital TCCC 29.87 5 Gujarat Gujarat Cancer Research Institute, Ahmedabad SCI 67.50 6 Goa Goa Medical College, Panaji TCCC 20.25 7 Haryana Civil Hospital, Ambala Cantt TCCC 20.25 8 Himachal Pradesh Indira Gandhi Medical College, Shimla TCCC 14.87 9 Himachal Pradesh Shri Lal Bahadur Shastri Medical College, Mandi TCCC 29.6362 10 Jammu & Kashmir Sher-i-Kashmir Institute of Medical Sciences, Srinagar SCI 47.25 11 Jharkhand Rajendra Institute of Medical Sciences, Ranchi SCI 22.95 12 Karnataka Kidwai Memorial Institute of Oncology (RCC), Bangaluru SCI 67.50 13 Mandya Institute of Medical Sciences, Mandya TCCC 17.257 14 Kerala Regional Cancer Centre, Tjiruvananthapuram SCI 46.957 15 Government Medical College, Kozhikode TCCC 25.03 16 Madhya Pradesh G.R. Medical College, Gwalior TCCC 18.90 17 Maharashtra Rashtrasant Tukdoji Regional Cancer Hospital & Research TCCC 20.176 Centre, Nagpur 18 Government Medical College, Aurangabad SCI 43.515 19 Vivekanand Foundation & Research Centre, Latur TCCC 20.25 20 Mizoram Mizoram State Cancer Institute, Aizawl TCCC 14.64 21 Nagaland District Hospital, Kohima TCCC 13.23 22 Odisha Acharya Harihar Regional Cancer Centre, Cuttack SCI 35.829 23 Punjab Government Medical College, Amritsar SCI 51.58 24 Civil Hospital, Fazilka TCCC 20.119 25 Rajasthan S P Medical College, Bikaner TCCC 17.123 26 SMS Medical College, Jaipur SCI 44.8077 27 Jhalawar Medical College & Hospital, Jhalawar TCCC 19.755 28 Sikkim Multispecialty Hospital at Sochygang (Sichey), near Gangtok, TCCC 29.02 Sikkim 29 Tamil Nadu Cancer Institute (RCC), Adyar, Chennai SCI 67.38 30 Telangana MNJ Institute of Oncology & RCC, Hyderabad SCI 18.12 31 Tripura Cancer Hospital (RCC), Agartala SCI 55.00 32 Uttar Pradesh Sanjay Gandhi Postgraduate Institute of Medical Sciences, TCCC 11.43 Lucknow 33 West Bengal Government Medical College, Burdwan TCCC 22.24 34 Murshidabad Medical College & Hospital, Berhampore, TCCC 10.9843 Murshidabad 35 Sagore Dutta Memorial Medical College and Hospital, Kolkata TCCC 20.25 Total 1131.6615